A SLAP tear is an injury to the labrum of the shoulder, specifically at the point where the biceps tendon attaches. SLAP stands for Superior Labrum from Anterior to Posterior. This area is particularly prone to injury as it has a poor vascular supply and therefore limited capacity for repair.

Mechanism of injury

Fall onto an outstretched hand

Repetitive overhead actions (such as throwing)

Lifting a heavy object

Symptoms

a catching sensation and pain with shoulder movements, most often overhead activities such as throwing

pain deep within the shoulder or at posterior of the shoulder joint

If associated with biceps tendonitis, patients may complain of pain over the anterior of the shoulder.

Diagnosis

Alongside physical examination, a contrast MRI with gadolinium injected into the shoulder can often help to identify a SLAP tear. In many cases, a confirmed SLAP tear can only be identified at the time of surgery.

Treatment

Initial rest and support of affected limb

anti-inflammatory medication

injections of cortisone to reduce inflammation in joint

Surgery

Types of SLAP surgery

Debridement

the torn portion of the labrum is shaved away to leave a smooth edge

results of surgery can be more predictable and rehabilitation is often not as restrictive as a SLAP repair

only suitable for minor tears that do not involve the biceps tendon.

SLAP repair

an arthroscopic procedure that uses sutures with anchors attached to resecure the torn labrum down to the shoulder socket

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